Cortical demyelination in PML and MS: Similarities and differences.

OBJECTIVE: To characterize pathologic changes in the cerebral cortex of patients with multiple sclerosis (MS) and progressive multifocal leukoencephalopathy (PML). METHODS: Autopsy brain tissue was obtained from 13 patients with PML, 4 patients with MS, 2 patients with HIV encephalopathy, and 1 subject without neurologic pathology. Immunohistochemistry for myelin proteins, inflammatory cells, and neurofilaments was performed to evaluate the distribution of cortical lesions, their inflammatory activity, and neuritic pathology. Confocal microscopy was applied to examine pathologic changes in neurites in PML cortex. RESULTS: Leukocortical, intracortical, and subpial patterns of cortical demyelination were represented in MS brain tissue. In PML brain tissue intracortical and leukocortical but not subpial lesions were observed. Cortical lesions in PML and MS contained fewer inflammatory cells than demyelinated areas in the white matter. Neuritic pathology in cortical PML lesions was represented by dystrophic and transected neurites. Pathologic modifications in neuritic processes in PML were more evident in highly inflamed white matter than in gray matter areas of demyelination, reminiscent of previous reports of neuritic pathology in MS. JC virus-infected cells were associated with PML white matter, leukocortical and intracortical lesions. CONCLUSIONS: Cortical pathology represents a distinct feature of progressive multifocal leukoencephalopathy. Similarities and differences with regard to multiple sclerosis cortical pathology were noted and may be informative regarding the pathogenesis of both disorders.

Inactivation of lck and loss of TCR-mediated signaling upon persistent engagement with complexes of peptide:MHC molecules.

T cell activation follows recognition of specific peptide:MHC molecule complexes in the context of proper costimulation. The earliest detectable event in T cell activation, within seconds of TCR ligand recognition, is tyrosine phosphorylation of TCR subunits. This causes a cascade of events leading to up-regulation of gene transcription that will drive T cell proliferation and differentiation. Regulation of TCR-mediated signaling upon T cell commitment is unclear. Here, we report that persistent stimulation of T cells, beyond 10 min, correlated with a reversible decrease in tyrosine phosphorylation of T cell lysates that did not affect T cell commitment to proliferation. Loss of Ag-induced tyrosine phosphorylation was not due to lack of Ag presentation, loss of TCR expression, or T cell death, but, rather, it was associated with a lack of TCR subunit tyrosine phosphorylation. We termed this phenomenon TCR desensitization by analogy to the loss of signaling observed in other receptor systems upon persistent engagement with agonist ligands. TCR desensitization correlated with surface reexpression of TCR without concomitant reexpression of coreceptor molecules. Biochemically, TCR desensitization correlated with increased levels of serine-phosphorylated lck, loss of lck kinase activity, and reversible loss of cytosolic lck. Thus, TCR signaling is regulated by desensitization that may be due to serine phosphorylation of lck causing inactivation and loss of this src kinase. This may have important implications by preventing TCR signaling and activation-induced cell death once the T lymphocyte is committed to proliferate.